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ANSWER KEY TO ENT QUESTIONS

  1. D – Boies p28054. A – Boies p506
  2. B – Boies p34255. B – Boies p522
  3. D – Boies pp345-34656. B – Boies p522
  4. D – Boies p47457. B – Boies p232
  5. B – Boies p28058. C – Boies p236
  6. B – Cummings p19559. A – Boies p179
  7. B – Cummings p19360. D – Boies p255
  8. C – Boies p47561. D – Boies p227
  9. A – Cummings p242562. D – Boies p226
  10. A – Caparas p19563. C – Boies p245. 336
  11. B – Boies p47864. B – Boies p530
  12. A – Paparella p240065. C – Boies p458
  13. C/D – Cummings p36666. B – Boies p212
  14. A – Cummings p1208 67. C – Cummings p268
  15. C – Boies p43168. D – Boies p218
  16. A – Boies p458 69. B – Mcquarie p712
  17. C – Boies p44870. B – Boies p321
  18. B – Boies p43471. C – Boies p386
  19. B – Boies p43072. C – Boies p393
  20. D – Boies p32773. A – Boies p461
  21. A – Cummings p99174. C – Boies 19
  22. A – Boies p14775. B – Cummings p1831
  23. C – Cummings p123476. D – Boies p390
  24. C – Boies p15177. B – Cummings p1847
  25. C – Boies p14378. D – Boies p407
  26. D – Cummings p174279. A – Boies p394
  27. C – Cummings p154580. C – Lee p830, 836
  28. C – Boies p44081. D – Boies p393
  29. C – Boies p53282. B – Boies p398
  30. C – Boies p53583. D – Boies p461
  31. C – Mcquarrie p67284. B – Boies p484
  32. A – Boies p53385. B – Boies p396
  33. C – Boies p52886. B – Boies p39
  34. A – Caparas p24087. C – Cummings 2645
  35. C – Caparas p23488. B – Boies p42
  36. D – Boies p52889. A – Boies p42
  37. A – Caparas p24090. A – Boies p39
  38. D – Boies p53591. A – Boies p140
  39. A – Boies p53592. B – Cummings p2708
  40. C – Boies p53593. C – Boies p134
  41. B – Caparas p24294. B – Boies p42
  42. B – Boies p53295. D – Boies p138
  43. C – Boies p52296. A – Boies p82
  44. B – Boies p51797. C – Boies p100
  45. C – Lee p965-96698. A/B/D – Boies p100
  46. A – Lee p92599. A – Boies p111
  47. C – Boies p510100. C – Boies p101
  48. A – Caparas p223
  49. D – Boies p510
  50. B – Caparas p216
  51. D – Boies p507
  52. A – Lee p960
  53. B – Caparas p224

EASTERN UNIVERSITY - Dr. NICANOR REYES MEDICAL FOUNDATION

Department of Otolaryngology - Head & Neck Surgery

Choose the best answer:

_____1. The phayrnx functions chiefly in:

a. Respiration and deglutition

b. Respiration, deglutition and voice resonance

c. Respiration, deglutition and voice production

d. Respiration, deglutition, articulation and voice resonance

_____2. Acute suppurative bacterial tonsillitis is most often caused by:

a. Group A beta-hemolytic streptococcus, staphylococci, C. Diptheriae

b. Group A beta-hemolytic streptococcus, H. Influenzae, Streptococcus viridans

  1. Group A beta-hemolytic streptococcus, Staphylococcus, Klebsiella
  1. H. Influenzae, Staphylococcus, Fusiform bacilli

_____3. A 25y/o male consulted at the OPD due to dysphagia of 2 days

duration. PPE: (+) trismus, increased salivation, swelling of the left side of the soft palate extending to the anterior pillar, pushing the uvula across midline. What is your working diagnosis?

a. Acute tonsillitis

b. Acute pharyngitis

c. Acute tonsillophayngitis

d. Peritonsillar abscess

_____4. Most important point in the history of foreign body ingestion:

a. Demonstrate the absence of foreign body

b. Ask patient to bring a duplicate of foreign body

c. Rely on diagnostics

d. Believe the patient

_____5. The pharyngeal phase of swallowing is completed by:

a. Elevation of the soft palate

b. Cricopharyngeal sphincter relaxation

c. Laryngeal elevation

d. Closure of the laryngeal aperture

_____6. The antibiotic of choice for Streptoccoccus pharyngitis in a 7-year old boy with Sickle Cell Trait:

a. Clindamycin

b. Penicillin

c. Sulfamethoxazole

d. Metronidazole

_____7. A 20-year old sailor has a persistent sorethroat and is found to have a pharyngitis with enlarged tonsils and cervical adenophaty . Gram stain of pharyngeal secretions shows gram- negative diplococci. These findings support a diagnosis of:

a. Streptococcal pharyngitis

b. Gonococcal pharyngitis

c. Haemophilus influenza

d. Bacteroides pharyngitis

_____8. Majority of foreign body coins will be trapped in the:

a. Gastroesophageal constriction

b. Aortic and bronchial constriction in the esophagus

c. Cricopharyngeal constriction

d. Tonsils

_____9. A 50 y/o female presents clinically with globus hystericus. This is usually associated with a/an:

a. A normal PE and barium swallow

b. Lesion of the upper esophagus

c. Abnormal direct laryngoscopy

d. Stricture of the upper esophagus

_____10. The absence of this structure distinguishes the esophagus from the

the rest of the gastrointestinal tract:

a. Serosa

b. Muscular

c. Submucous

d. Mucosa

_____11. The tone and function of the esophagus is best evaluated by:

a. Plain x-rayc. Esophagoscopy

b. Cineradiographyd. Ct scan

_____12. Majority of ‘fish spine” foreign bodies will be lodged in the

a. Tonsilsc. Epiglottis

b. Valleculad. Tongue

_____13.Caustic substance ingestion can affect which stages(s) of swallowing:

a. Stage Ic. Stage III

b. Stage IId. Stage IV

_____14. What is the most common cause of deep neck infections in adults?

a. Odontogenic sourcesc. Surgical wound infection

b. Foreign bodiesd. Spread of superficial infections

_____ 15. An example of an indirect diagnostic test for neck masses:

a. Needle biopsyc. Ultrasound

b. Open biopsyd. Fine needle aspiration

_____16. Squamous cell carcinoma is the most common malignant tumor of the

paranasal sinuses. The most commonly affected paranasal sinus by this tumor is:

A. Maxillary sinusC. Frontal sinus

B. Ethmoid sinusD. Sphenoid sinus

_____17. Which of the following statements is true regarding basal cell CA:

A. Basal cell CA carries a worse prognosis

B. It does not cause extensive local destruction even if left untreated

C. It is the most common skin malignancy

D. It is more common in the lower lip

_____18. A surgical procedure used as a treatment for thyroglossal duct cyst which include the removal of the central portion of the hyoid bone to ensure complete removal of the cyst is known as:

A. Caldwell-luc procedureC. FESS

B. Sistrunk procedure D. Thyroidectomy

_____19. At what level of the neck can you palpate the superior deep jugular

lymph node?

A. Level IC. Level III

B. Level IID. Level IV

_____20. Whartin’s tumor is a relatively common benign salivary gland tumor

that usually occur among:

A. Baby boyC. Adolescent bachelor

B. Teenager schoolboyD. Adult male

_____21. How much of the actual total daily volume of salivary production comes from the parotid and submandibular glands?

a. 90%b. 50%

c. 30%d. 10%

_____22. Schirmer’s test is considered positive if the difference between the ipsilateral and contralateral results exceed a difference of:

a. 25%

b. 50%

c. 75%

d. Greater than 90%

_____23. A 30 year old female comes in with fever, pains in the right pre-auriculararea. On examination, you see a swollen, tender, erythematous

right parotid area. The orifice of the stensen’s duct is also swollenwith minimal purulent material coming out. What is the diagnosis?

a. Sialolithiasis

b. Chronic sialadenitis

c. Acute bacterial sialadenitis

d. Mumps

_____24. Sudden facial paralysis associated with vesicles in the external

audiotory canal andpinna:

a. Melkersson’s syndrome

b. Bell’s palsy

c. Ramsay hunt syndrome

d. Schwannoma

_____25. Which branch of the facial nerve is responsible for secretomotor function of submandibular gland?

a. Greater Superficial Petrosal Nerve

b. Stapedius

  1. Chorda tympani
  2. sphenopalatine

_____26. Primary neoplastic growth that metastasizes to the supraclavicular area may come from neoplasm involving the:

a. Tonsils

b. Maxilla

c. Tongue

d. Esophagus

_____27. A middle lower lip lesion would drain into the:

a. Submandibular node

b. Mentum of the mandible

c. Submental node

d. Floor of the mouth

_____28. A 54 y/o patient presented with a midline mass that moves with deglutition. Your primary diagnostic impression as to its nature

would be:

a. Thyroglossal duct cyst that manifested late in life

b. Thyroid nodule, probably benign

c. Thyroid malignancy

d. Inflammatory nodule

_____29. The second most common fracture in the face is:

a. nasal bone fractureb. Alveolar ridge fracture
c. Mandibular fractured. Zygomatic fracture

_____30. Blow-out fracture from a blunt object hitting the eye occurs at

a. The lamina papyracea, the thinnest bone in the body
b. The lacrimal bone
c. The floor of the orbit
d. The zygomatic bone, hence its propensity to be found

simultaneously with a tripod fracture

_____31.The best replacement fluid to use for hypovolemic shock is:

a. Lactated Ringer’s solution

b. Dextran Plasma Expander
c. Whole Blood

d. packed red blood cells transfusion

_____32.The best material for use in internal fixation for fracture is:

a. titanium plate

b. stainless steel plate

c. Glass

d. stainless steel wire

_____33. The best x-ray view to request for suspected nasal bone fracture is:

a. CT scan

b. Transorbital view

c. Soft tissue lateral view

d. AP view

_____34. The best x-ray view to request for a suspected zygomatic arch fracture

is:

a. Basal view of the skull

b. Modified towne’s view

c. Mayer’s view

d. Lateral view of the skull

_____35. To visualize the condylar neck of the mandible, one would request for

an x-ray projection:

a. Mandible lateral view

b. Mandible oblique view

c. Modified Towne’s view

d. Water’s view

_____36. A fracture of the body of the mandible is best visualized by:

a. Mandible AP view

b. MRI scan

c. Transorbital view

d. Mandible oblique view

_____37. Of the following, which fracture produces epistaxis?

a. Tripod fracture

b. Depressed zygomatic arch fracture

c. Alveolar ridge fracture

d. Mental fracture of mandible

_____38 Hypesthesia of the cheek due to inferior orbital rim fracture is due to

involvement of which nerve?

a. Supratrochlear nerve

b. Sphenopalatine ganglion

c. Greater palatine nerve

d. Inferior orbital nerve

_____39. Hypesthesia of the cheek is associated with:

a. Inferior orbital rim fracture c. Le fort I fracture

b. Depressed zygomatic arch fracture d. Nasal bone fracture

_____40. Which of the following is NOT associated with epistaxis?

a. Tripod fracture

b. Lefort II fracture

c. Depressed zygomatic archfracture

d. Blow-out fracture

_____41. “Tear- drop” sign on Water’s x-ray view is evidence for presence of :

a. Lacrimal bone fracturec. Frontal sinus fracture

b. Blow-out fracture d. Alveolar ridge fracture

_____42. The treatment of choice for alveolar ridge fracture is:

a. Titanium plating c. Barton’s bandaging

b. Interdental wiring d. Intermaxillary wiring

_____43. Procedure of choice for sagging double chin in 24 y/o female

a. Mentoplastyc. Submental lipectomy

b. Submental neck dissectiond. Submental liposuction

_____44. A scar that usually stays within the boundaries of the wound and

occur more frequently in areas of motion or skin tension

a. Keloidc. Unsightly scar

b. Hypertrophic scard. Trap door deformity

_____45. The blood supply of a free flap is derived from:

a. A neighboring artery in the recipient site

b. The capillaries in the recipient site

c. The arterial supply in the donor site

d. The capillaries in the donor site

_____46. Augmentation rhinoplasty maybe achieved by any of the following,

EXCEPT:

a. Silicone injectionc. Bone graft

b. Silicon implantd. Cartilage graft

_____47. Undue wound tension is best avoided by ______.

a. Stretching the skin to reduce tension

b. Drainage of hematoma

c. Tissue undermining

  1. Proper choice of suture material

_____48. Injection of fat harvested from the same individual is called ______.

a. Autologous fat transferc. Heterologous fat transfer

b. Homologous fat transferd. None of the above

_____49. The most inert suture material

a. Chromic cutgutc. Polyglycolic acid

b. Plain catgutd. Nylon

_____50. Decreases rate of wound healing

a. Silver sulfadiazinec. Neomycin cream

b. Triamcinoloned. Penicillin G

_____51. To reduce local bleeding from the operative site in the face, it is a

common practice to mix lidocaine with ______.

a. Steroidsc. Normal saline solution

b. Sodium bicarbonated. Adrenaline

_____52. A graft derives its blood supply from ______.

a. Capillaries in the recipient site

b. Arterial supply in the donor site

c. A neighboring artery in the recipient site

d. Capillaries in the donor site

_____53. The best rate of take is from ______.

a. Full thickness skin graftc. Thin skin graft

b. Partial thickness skin graftd. Axial skin flap

_____54. The least contraction is exhibited by ______.

a. Full thickness skin graftc. Thin skin graft

b. Partial thickness skin graftd. Axial skin flap

_____55. A skin chemical peel aims to ______.

a. Remove scar c. Remove unwanted hair

b. Eliminate fine wrinkles d. Improve blood supply to the area

_____56. Procedure of choice for a 60y/o female with sagging double chin

a. Submental liposuction c. Submental neck dissection

b. Submental lipectomyd. Reduction mentoplasty

_____57. Ophthalmic artery is a branch of ______.

a. External carotid arteryc. Sphenopalatine artery

b. Internal carotid arteryd. Ethmoidal artery

_____58. This is considered the most common source of profuse epistaxis

especially in adult

a. Anterior ethmoidal arteryc. Sphenopalatine artery

b. Posterior ethmoidal arteryd. Greater palatine artery

_____59. Which of the following drains into the middle meatus?

a. Anterior ethmoidc. Sphenoid

b. Posterior ethmoidd. Nasolacrimal duct

_____60. Headache of sphenoid sinusitis is projected where?

a. Frontalc. Interorbital

b. Cheekd. Occipital

_____61. Nasal obstruction due to pregnancy and hormones are classified under

which type of rhinitis?

a. Structuralc. Allergic

b. Infectiousd. Vasomotor

_____62. Rhinitis medicamentosa is due to overuse of

a. Oral steroidsc. Oral decongestants

b. Local steroidsd. Local decongestants

_____63. Which condition usually presents as profuse epistaxis?

a. Lymphoepitheliomac. Juvenile angiofibroma

b. Inverting papillomad. Glioma

_____64. A sequela of untreated septal hematoma

a. Anosmiac. Impaired ciliary movement

b. Saddle nose d. Sinusitis

_____65. The most commonly involved site in malignancy of the nose and the

paranasal sinuses

a. Frontal sinusc. Maxillary sinus

b. Ethmoid sinusd. Nasal cavity

_____66. A 40 year-old male presents with nasal obstruction, blood-streaked

nasal discharge, impaired hearing on the right and a 2 X 2 cm hard, right infra-auricular mass. The most likely cause of the nasal obstruction is

a. Structural disorderc. Allergic rhinitis

b. Inflammatory disorderd. Vasomotor rhinitis

_____67. Cause of the immediate rhinitis symptoms in allergic rhinitis

a. Influx of eosinophilsc. Breakdown of mast cells

b. Influx of basophilsd. Breakdown of basophils

______68. Which of the following best describe a patient with allergic rhinitis?

a. Presence of purulent discharge with headache

b. Presence of watery nasal discharge with headache

c. Presence of purulent nasal discharge with obstruction

d. Presence of watery nasal discharge with obstruction

_____69. A coagulation disorder of the congenital type which may be a cause of

epistaxis and characterized by a prolongation of the prothrombin time and/or the PTT.

a. Hemophiliac. Liver failure

b. Vit K deficiencyd. Osler weber rendu disease

_____70. An autosomal dominantly inherited vascular anomally characterized by

abnormal subepithelial vessels, multiple cutaneous telangiectasia,

frequent epistaxis and gastro intestinal bleeding

a. Von willebrand’s diseaseb. Osler weber-rendu disease

c. Hemangiomatad. Hemophilia A

_____71. “Bowing” of the vocal cords on phonation is due to a non-functioning:

a. Posterior cricoarytenoid

b. Interarytenoid

c. Thyroarytenoid m.

d. Cricopharyngeal m.

_____72. Laryngomalacia is present due to a defect in which structure:

a. Thyroid cartilage

b. Cricoid cartilage

c. Epiglottic cartilage

d. Tracheal cartilage

_____73. Laryngeal carcinoma with the best prognosis:

a. Glottic CA

b. Supraglottic CA

c. Subglottic CA

d. Transglottic CA

_____74. The best way to examine the larynx in the OPD is by:

a. Direct laryngoscopy

b. Palpation

c. Indirect laryngoscopy

d. Lateral neck x-rays

_____75. The sensory arm of the cough reflex is innervated by the:

a. Inferior laryngeal nerve

b. Superior laryngeal nerve

c. Hypoglossal nerve

  1. Mental nerve

_____76. Pitch of the voice is controlled by:

a. Pressure of the tracheal air column

b. Length of the vocal cords

c. Tension and bulk of the vocal cord

d. All of the above

____77. The structure mainly responsible for prevention of aspiration is:

A. TongueC. Epiglottis

B. Vocal cordsD. True vocal cords

_____78. Unilateral recurrent laryngeal nerve paralysis will result in:

A. Breathy voiceC. Good airway

B. Stridor in childrenD. All of the above

_____79. Congenital subglottic stenosis is defined as a subglottic diameter less

than

A. 4 mmC. 4 inches

B. 4 cmD. 4 feet

_____80. Bowing of the true vocal cords is caused by the paralysis of:

A. Posterior cricoarytenoid muscleC. Interarytenoid muscle

B. Lateral cricoarytenoid muscleD. Sternothyroid muscle

_____81. A 1 1/2 month-old baby girl was brought to your clinic because of

stridor. There was no associated cough. The patient was delivered to a G8P7 40 year old laundrywoman from payatas via NSD. Birthweight was 6.5lbs with APGAR score of 9 and 10. She was sent home after 2 days with no perinatal complications. She had a good suck with normal swallowing, good cry and weight gain. Stridor is slightly relieved by putting her in a supine position. T=37.2 C ; RR= 40/min.

Your initial impression is:

a. Congenital subglottic stenosis

b. Congenital laryngeal web

c. Laryngocoele

d. Laryngomalacia

e. Congenital cyst

_____82. A 6 year-old boy was brought in to the clinic because of cough

associated with moderate-grade fever and sorethroat characterized by painful swallowing few days PTC. The patient was sent home with antibiotics, cough syrup and antipyretics. The following day, patient was brought to the ER because of stridor associated with cyanosis. Patient was relieved by sitting up with mouth open and chin forward. He was restless and cyanotic with flaring of alae nasi, substernal and intercostal retractions. T=40C ; RR=36/min.

Your initial impression is:

a. Drug allergy

b. Acute epiglottitis

c. Acute subglottic laryngitis

d. Foreign body in laryngotracheobronchial tree

_____83. A 62 year old farmer from Iriga City came in because of dyspnea. His condition started 10 months PTC as hoarseness associated with hemoptysis. One month PTC, he developed persistent dyspnea accompanied by a lump on the right side of the neck. Patient is a chronic alcoholic and smoker. On PE, patient is obese, afebrile, and in respiratory distress.

Your initial impression is:

a. Chronic non-specific laryngitis

b. Pedunculated vocal cord polyp

c. Laryngeal papilloma

d. Laryngeal CA

______84. A 3 year-old girl was taken to the ER because of stridor and

cyanosis. Few hours PTC, patient was playing in the sala while her daddy was eating peanut while watching world meeting of families. The patient was restless with audible slap and palpable thud.

Your initial impression is:

a. Bronchial foreign body

b. Tracheal foreign body

c. Tracheomalacia

d. Esophageal foreign body

_____85. While on duty at the ER, a patient was brought in due to hoarseness and coughing out of blood. Patient was the driver of a car involved in a vehicular accident moments ago. From the history, you learned that unfortunately he was not wearing his seatbelt and was thrown forward on the steering wheel upon impact. Examination revealed a patient in moderate respiratory distress with stridor. Your most likely diagnosis is:

a. Laryngitisc. Aortic arch aneurysm

b. Laryngeal fractured. Laryngeal foreign body

______86. Deflection of the kinocillium away from the stereocilia results in

a. In6crease of discharge rate

b. Decrease of discharge rate

c. Increase then a decrease in discharge rate

d. Decrease then an increase in discharge rate

______87. The single most important test to request in cases of vertigo is

a. Dix-hallpike test

b. Posturography

c. Electronystagmography

d. Caloric stimulation

_____88. ENG(electronystagmography) works on the principle of voltage

difference between the

a. Cornea and eyelid

b. Cornea and retina

c. Right and left cornea

d. Right and left retina

_____89. In caloric stimulation a cold fluid is applied to the right ear. The

expected resulting nystagmus is

a. A slow phase to the right

b. A slow phase to the left

c. Clockwise

d. Counterclockwise

_____90. The utricle of the inner ear responds to

a. Linear acceleration

b. Angular acceleration

c. Cold water stimulation

d. Warm water stimulation

_____91. A round window fistula is best treated by

a. A flat graft to the round window

b. Simple observation and watchful waiting

c. Labyrinthectomy

d. Lazer welding of the leak

____92. Motion sickness is due to

a. Allergy and histamine

b. Visual and vestibular information mismatch